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8 Factors to Consider Before Buying Long-Term Care Insurance

25 Comments

How does one enforce a facility policy. We can't collect. My Mother has been paying $1,000 a month for 15 years. She now needs a Nurses Assistant 24 x 7. I am staying with her 12 hours a day. She is in Personal Care where Nurses Aids check on her during the night. There is an alert system but no room monitors. She has more than 2 qualifiers for 24 x 7 care. Where can I go to get enforcement of the policy she purchased for $150,000.00 over 15 years. I am being retaliated against for asking about this and other problems too numerous to list all here. This is a dangerous situation. Each night I leave her, she asks, will you be here in the morning. I answer yes and give her the time and we pray that God will keep her safe during the night. It is a big risk that she could fall. Some nights she is wobbly. When I get there in the morning her walker is left at the toilet. She is walking back and forth herself. Tonight she was delerious all evening. She is having blood tests tomorrow.

I appreciate knowing about the claim jockey. That would have been helpful. I can see there are still areas family or an advocate are needed, such as monitoring the caregiver hours, and making sure info is available to whomever needs it, but overall, it would have been helpful. Since I've not heard of it, I will pass info on. Thanks.

@Twinflower1: Good comments. There is now a company that will take care of all these pesky claim details. Contact Claim Jockey. The nurse from Genworth is there to help fill in the initial paperwork, too. Once the claim is approved, time sheets can be filled in by the worker, and the claimant or their family can just make sure they are accurate before sending them in for reimbursement.

This is a good article. I would add another dimension to the discussion in the arena of collecting the insurance. Who will be the person applying for the insurance when it is needed (often the purchaser is unable to master the complexities involved) and who will monitor payments, arrange visits from nurses that are required, and do the legwork regarding changing addresses, following up on changes when a client has to move from assisted living to memory care of any other situation regarding a change of living status for the client.
I have been told that by the time a person needs and is qualified for long term care insurance, they often are not able to handle the application process. Having gone through that process, with an Aunt who was unable to do it, I am firmly going to advocate that anyone purchasing long term care insurance know that a third party will be needed to handle the application and monitoring..
Genworth sends nurses to meet to the client and observe their condition. They make appointments and spend an hour to an hour and a half asking questions and asking patients to perform tasks so their level of function can be quantified.
My Aunt was upset at the length of the interview and felt someone was trying to do something to her. She was in a mild form of dementia at the time, but I needed to calm her. I personally would have been exhausted after the lengthy evaluation.
They need providers names, addresses and numbers, and often they need information that only family or a close caregiver can give. During the initial interview, the facility nurse was present and unable to answer all the questions. They either didn't know my Aunt well enough, or they didn't have a complete history. The insurance company also needs legal documentation before they can talk to you.
Throughout the process of collecting long term care insurance (five years), my experience is that "glitches" occur regularly. The facility bills, the insurance company deposits into the bank a reimbursement payment. Only it doesn't happen like that all the time. The facility can send the paperwork, but the insurance company doesn't get it. There can be as many as five attempts to get the billing through. It usually requires a phone call to resolve the issue. I used to be notified by mail when a claim was not received by the insurance company. I could alert the facility who would also receive a notice a claim was not received. Now I receive a notice that my Aunt's premiums are being reinstated. If you're wondering, the insurance company didn't receive a claim, assumes my Aunt is no longer in the facility and ends her benefits. I keep a very close watch on the deposits to her account, If nothing appears when there should be a deposit, I prompt the facility that their billing didn't go through. If no one was watching, all payments would stop. If you rely on the reimbursement payment for current bills, things get out of hand quickly if the deposit doesn't arrive. While saying this, there are also stretches where all goes well. If the facility changes bookkeepers, be prepared to instruct them on how your insurance company works and whom to call to put eyes on your billing.
I have found that the insurance company is very willing to correct mistakes. But they make it very easy to have benefits stopped. I would also recommend coverage to the full extent allowed per day. My Aunt purchased insurance that was adequate for the time period she was in at the time of purchase. Daily expenses have doubled since that time for assisted living and nursing home care. She also had a dollar limit on her policy. I would get one for the duration if you can afford it.
If you are expecting to take care of all the application paperwork yourself, or think the facility will take care of the paperwork, you are probably not going to be able to claim your benefits. Your POA or trustee needs to be on the ball.

Hi cpegas,

The person who told you that you could only buy 2 to 5 years of LTCi benefits is mistaken.

In 49 states (including KY) there is a policy offering long-term care coverage that is unlimited. There's no cap on how much it can pay in benefits over your lifetime.

In 50 states a couple can share two policies that combined can pay benefits for at least 16 years.

In 48 states a couple can share two policies with $1.5 million dollars of long-term care benefits.

If the person who told you that you could only buy 5 years of benefits is an insurance agent, it might be that he/she does not represent the companies that offer these larger benefits.

I'm sorry to hear about your mother. It's important that anyone who purchases a long-term care policy let their close relatives or friends know about the policy so that a claim is made on the policy.

Also, with all policies today that meet the federal guidelines, the insurance company has to send notices to those you designate if a premium is not paid on time. This is to prevent your policy from lapsing. The people you designate to receive these notices will know about your policy and they can also be there to make sure that a claim is filed when you need care.

Scott A. Olson
LTCShop

ScottAOlsonLTC, I would like to know where you got your info from. Every policy I looked into offered only from 2 - 5 yrs stating that that is the most they expected someone to survive in a NH. Maybe it differs in different states. That is the way it is in KY. Also, when the subscriber stops payment, or has no more sense to continue, if they have up to a year to get partial reimbursement back, regardless of mental state. She was paying $7000.00 a year for her. Mother lost $130,000.00 because she did not understand to submit a request. It was too late before I found out. The insurance co basically said to bad so sad, get lost. Go ahead, they said, and get an lawyer, it won't do you any good. It didn't. She could have used that money. Dad lasted a year & got his benefit, but be careful, Mom's premiums more than tripled after he died in 99. Mom had to pay up front monthly, out of their stocks and then was reimbursed by the insurance sometime afterward, rather than the insurance co paying direct. Read the small print, please.

Long-term care insurance, as described in infolongtermcare.org is a product that may not fit everyone, but if you have the funds, then you should buy it. The guides provided herein are helpful so that you can tailor a policy that best suits your needs and preference, the key to having a good long-term care insurance coverage is to avoid over-insuring. No individuals are the same in as much as no long-term care insurance policies are ever the same so plan carefully and do not forget to consider the tips listed here, make sure to talk to an expert before shopping for long-term care insurance.

Long-term care insurance, as described in infolongtermcare.og is a product that may not fit everyone, but if you have the funds, then you should buy it. The guides provided herein are helpful so that you can tailor a policy that best suits your needs and preference, the key to having a good long-term care insurance coverage is to avoid over-insuring. No individuals are the same in as much as no long-term care insurance policies are ever the same so plan carefully and do not forget to consider the tips listed here, make sure to talk to an expert before shopping for long-term care insurance.

I would just like to add that considering the financial rating of long term care insurance companies is important since freeltcquotes claims that it can help consumers find a company that can meet the claims of policyholders, provide high quality services and very stable. Most people forget this, which often leads to a problem especially when it's time for them to file for claim.

By following these tips, I'm pretty sure consumers will find the appropriate carrier and policy type for them.

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Considering these things before buying long term care insurance can actually save you money. Long term care insurance cost can go around $1,000 to $7,000 annually which is a bit pricey for people who have other financial responsibilities. These tips are beneficial to those who have a limited budget but keen in having a policy. I just hope consumers will use these guidelines before purchasing coverage.